In the past year, you might have visited your general health practitioner for a physical, your cardiologist for an EKG or your dentist for a cavity check. But did it ever occur to you to get screened for depression? If not, now is your chance. Thursday is National Depression Screening Day – an annual, large-scale public campaign in which physicians, colleges, community institutions and hospitals across the country offer free, anonymous depression screenings for anyone who wants to take care of their brain as well as their body.
Douglas Jacobs, an associate clinical professor of psychiatry at Harvard Medical School, founded National Depression Screening Day in 1991. Jacobs had witnessed many of his colleagues in the medical community issue self-screenings to patients for physical conditions (such as breast examinations for cancer or blood pressure questionnaires). He was inspired to apply the same clinical methodology to mental health after the National Institute of Mental Health published a groundbreaking study stating that depression was a prevalent – but severely under-diagnosed and under-treated – disorder.
Jacobs was troubled by the study’s revelation that many people didn’t seek a proper diagnosis due to stigma or a lack of awareness about their condition.
“Depression is an illness,” he says. “It can be seriously debilitating, and can interfere with people's performance at work, their relationships and their health. And most importantly, it can lead to suicide. The earlier you get treatment, the more likely for a positive outcome.” An easy and private screening process, he thought, would increase patient awareness and help people feel comfortable addressing the fact that they might have a form of mental illness – one of medicine’s last lingering taboos.
In today's era of WebMD and other self-diagnosis websites, it's hard to imagine a time when the idea of answering a few questions to screen for a disease wasn't a widespread practice. But in 1991, says Jacobs, the idea was a novel one in the mental health community. "No one had really thought you could gain much from a five- or 10-minute interview," he says. "The idea was that it would identify those who could be at risk for having depression and push them to go seek a complete examination. It's not an official diagnosis, but it's a strong [signal] that someone might be suffering from depression, [and one] that can be confirmed by a full examination."
Jacobs designed a question and answer-based test, using a self-report scale to check off the criteria for depression listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. He successfully piloted the screening – back then, it was only for depression, although it’s now expanded to include other psychiatric conditions – at a Boston-area hospital. Soon after, Jacobs pitched the idea of National Depression Screening, an annual event filled with voluntary screenings and public awareness campaigns, to the American Psychiatric Association. He garnered support from additional hospitals, and before long his brainchild had ballooned into both a nationally recognized event and a Boston-area nonprofit, Screening for Mental Health, which creates various mental health assessment tools for colleges, the military and the general population. .
How does someone get screened for depression? Just like any other disease, mental illness has specific signs and symptoms. For example, people with depression might feel a lack of energy, a decrease in appetite and a general loss of enjoyment in activities that were once pleasurable. Sometimes these feelings go away; other times they linger and can disrupt day-to-day moods or routines. Recognizing and identifying various patterns, however, can help someone find a name – and a treatment – for what’s going wrong.
You can receive a mental health screening at participating hospitals, community centers and colleges across the country. But if you can’t find one in your area, don’t panic.
By going to the website Help Yourself Help Others, which is sponsored by the Screening for Mental Health, you can take a quiz that will help determine if you might be suffering from various illnesses ranging from depression and anxiety to bipolar disorder, eating disorders and post-traumatic stress disorder. After answering a series of questions regarding your moods, thoughts, eating/drinking habits, sleep patterns and other factors, the questionnaire evaluates your symptoms and provides a likely diagnosis. But since the screening isn’t an official checkup, it also advises you to seek a professional evaluation and lists local resources where you can seek further counsel from a therapist or physician. From them, you can learn more about common treatments, including various types of medication and therapy.
The main reason to do a mental health screening lies in the numbers: Depression and other forms of mental illness are as common as they are misunderstood. In 2012, an estimated 16 million adults in the U.S. had at least one major depressive episode, according to the National Survey on Drug Use and Health. Suicide is the 10th leading cause of death for Americans, according to a 2011 data analysis by the Centers for Disease Control and Prevention. And about 11 percent of adolescents have a depressive disorder by age 18, the NIMH says.
But despite these staggering statistics, a 2014 study conducted by the journal Psychological Medicine found that, for myriad reasons, people often don’t seek mental health treatment. They worry about confidentiality issues or stigma and feel as though they can tackle the problem themselves without a professional’s help. Additionally, they either have a low knowledge of available mental health services or they don’t know how to access them.
Although some doctors ask patients about their moods during annual checkups, not all do, Jacobs says. “In primary care offices, depression might not get a diagnosis,” he says. “It's not a question of doctors doing anything wrong” – it’s just that patients and physicians alike are often conditioned to concentrate on the body from the neck down. By educating themselves through a mental health screening, Jacobs says, patients can feel empowered to initiate the conversation with their doctor.
James David, a psychotherapist who runs his own private practice in Silver Spring, Maryland, runs a professional website on which he posts mental health facts, articles and links – including to Help Yourself Help Others. “I think of it as a public service-type website," he says. “Anyone can access the site. And if they access the mental health screening, they can fill out the scales for anxiety, depression post-traumatic stress disorder, etc. People come to my website, and they take the test. They may or may not follow up and come and see me. And that's fine.”
David doesn’t view the test as a definitive diagnosis – but he does say it often points a person in the right direction. “A high percentage of people who have depression, anxiety or other disorders will never come in for treatment. They're in denial, they can't afford it or they're embarrassed,” he says. “So a depression screening is an extremely positive thing. The more people that avail themselves of the depression screening service, the more people will probably come in for treatment, and that’ll be a better result for society as a whole.”
Every year, there’s a theme for National Depression Screening Day. This year, it’s a focus on the connection between physical and mental health, says Sue Thorne, director of communications for Screening for Mental Health. “Mental health needs to be viewed and treated in the same way that physical health is,” she says. "There are so many links between the two that it’s important for people to see [the mind and the body] as a holistic issue.”
Throughout the years, Jacobs says, society has become more accepting of mental illness – a far cry from when the NIMH first released the study that spurred him to action. “The stigma is still there,” he says. But today, he adds, it’s lessened, and many more people with depression get treatment for it than they once did. “I’d like to think [Screening for Mental Health] has made a difference for some of the current statistics,” he says.